K.D.SHAHI,PRESIDENT - (1.) THIS is an appeal against the order dated 17.10.2003 passed by the District Forum, Nainital whereby the complaint of the complainant was dismissed for recovery of the insured amount of the insured under Janta Personal Accident Insurance Policy.
(2.) THE brief facts of the case are that the father of the complainant Sh. Jagat Singh was insured for a sum of Rs. 5,00,000/ - on 12.9.1996. The age of the insured was given as 68 years in the policy and there is no dispute regarding payment of premiums etc. According to the complainant on 11.1.2000, the insured Sh. Jagat Singh fell in the bathroom, received severe head injury and as a result of haemorrhage from the said injury, he died. The complainant completed all the formalities but on 17.10.2000 the Insurance Company repudiated the claim of the complainant treating the death of the insured as a natural death. Therefore, the complainant filed the complaint.
(3.) AFTER taking the evidence of the parties and hearing them the learned Forum rejected the complaint, against which order the present appeal has been filed. We have heard the learned Counsel for the parties and gone through the records. The only dispute is whether the insured has suffered any head injury or not? Whether he died out of haemorrhage from the said injury or whether he died a natural death? The brief facts are that Sh. Jagat Singh shown to be aged 85 years in the records of the hospital was admitted in Susheela Tiwari Memorial Forest Hospital, Haldwani on 7.1.2000. He was discharged on 10.1.2000. The papers of the hospital show that he was discharged from the hospital. The papers of the said hospital also show that the insured had a tendency to fall down. The insured died on 11.1.2000 as alleged due to fall in the bathroom and as a result of head injury due to this fall. The information of the death of the insured was given to the Insurance Company on 24.1.2000 after 15 days of the death. The Insurance Company files objections before the learned Forum that there was no FIR, no post -mortem. Had immediate information been given to it, it could have enquired into the cause of death and could have secured post -mortem but it was not done. However, an inquiry was made by the Insurance Company and the Investigator/Surveyor gave his report dated 30.3.2000.;